腹膜透析和血液透析对终末期肾脏疾病患者钙磷代谢及微炎症状态的影响  

Effects of Peritoneal Dialysis and Hemodialysis on Calcium-Phosphorus Metabolism and Micro Inflammatory State in Patients with End-Stage Renal Disease

作　　者：张道法 陈道军[1] 武伟[1] 魏佳莉[1] 黄云[1] ZHANG Dao-fa; CHEN Dao-jun; WU Wei; WEI Jia-li; HUANG Yun(Department ofNephrology, Hainan Provincial People＇s Hospital, Haikou, Hainan, 570311, China)

机构地区：[1]海南省人民医院肾内科,海南海口570311

出　　处：《现代生物医学进展》2018年第17期3360-3364,共5页Progress in Modern Biomedicine

摘　　要：目的:探讨腹膜透析(PD)和血液透析(HD)对终末期肾脏疾病(ESRD)患者钙磷代谢及微炎症状态的影响。方法:选择2016年1月~2017年2月我院收治的ESRD患者94例为研究对象,采用随机数字表法分为PD组(47例)和HD组(47例),PD组给予非卧床持续性PD治疗,HD组给予HD治疗,治疗6个月后比较两组血清钙磷代谢水平和微炎症状态,并统计两组并发症的发生率。结果:治疗6个月后,两组血清钙水平与治疗前相比显著升高,血清磷水平显著降低(P<0.05),但HD组与PD组比较无差异(P>0.05);治疗6个月后,两组血清C-反应蛋白(CRP)水平较治疗前明显升高,且HD组高于PD组,差异有统计学意义(P<0.05),治疗6个月后,两组降钙素原(PCT)水平与治疗前相比显著降低,差异有统计学意义(P<0.05),但HD组与PD组比较无差异(P>0.05);PD组感染、低蛋白血症的发生率高于HD组,HD组高血压、心律失常、充血性心衰的发生率高于PD组,差异均有统计学意义(P<0.05)。结论:PD和HD治疗均可改善ESRD患者钙磷代谢紊乱,但两者都将加剧患者微炎症反应,其中HD对患者微炎症状态的影响更大。Objective： To explore the effects of peritoneal dialysis （PD） and hemodialysis （HD） on calcium-phosphorus metabolism and micro inflammatory state in patients with end-stage renal disease （ESRD）. Methods： 94 patients with ESRD who were treated in our hospital from January 2016 to February 2017 were selected as the subjects, the patients were divided into PD group （47 cases） and HD group （47 cases） by random number table, the PD group were treated with ambulatory continuous PD treatment, the HD group were treated with HD, after 6 months treatment, the levels of serum calcium, phosphorus metabolism and micro inflammation were compared between the two groups, the incidence of complications in the two groups was also counted. Results： After 6 months treatment, the serum calcium levels of the two groups increased significantly, serum phosphorus levels decreased significantly （P〈0.05）, but there was no significant difference between the HD group and the PD group （P〉0.05）. After 6 months treatment, the levels of serum c-reactive pro- tein （CRP） in two groups were significantly increased, and the HD group was higher than the PD group, the differences were statistically significant （P〈0.05）. After 6 months treatment, the level ofprocalcitonin （PCT） was lower than that at before treatment, the difference was statistically significant （P〈0.05）, but there was no significant difference between the HD group and the PD group （P〉0.05）. The incidence of infection and hypoproteinemia in PD group were higher than that in HD group, and the incidence of hypertension, arrhythmia and congestive heart failure in HD group were higher than that in PD group, the differences were statisticaUy significant （P〈0.05）. Conclusion： The PD and HD treatment both can improve the metabolism of calcium and phosphorus in patients with ESRD, but both of them will aggravate the micro inflammatory reaction, and HD has more influence on the micro inflammatory state of the patients.

关 键 词：终末期肾脏疾病 腹膜透析 血液透析 钙磷代谢 微炎症状态 

分 类 号：R459.5[医药卫生—治疗学] R692[医药卫生—临床医学]